NPIMap

Organization Active NPI

Specialized Therapies for Autism and Related Services

  • Behavior Analyst
  • Gretna, LA
National Provider Identifier
1104352038
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
L-155 Issued in LA
Legal business name
SPECIALIZED THERAPIES FOR AUTISM AND RELATED SERVICES
Practice address
3202 Mallard LN
Gretna, LA 70056-7795
Phone
(916) 397-4045
NPI assigned
May 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Julie Bartlett Hickerson, MS, BCBA, LBANPI 1922454370
Title
Owner/Clinical Director
Phone
(916) 397-4045

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X L-155 LA Primary

Addresses

Primary practice location

3202 Mallard LN
Gretna, LA 70056-7795

Mailing address

3202 Mallard LN
Gretna, LA 70056-7795
Phone (916) 397-4045

Other names 1

  • S.T.A.R.S. Consulting, LLC Other name

National Provider Directory

National Provider Directory

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1104352038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3202 MALLARD LN",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700567795",
            "telephone_number": "916-397-4045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3202 MALLARD LN",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700567795",
            "telephone_number": "916-397-4045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALIZED THERAPIES FOR AUTISM AND RELATED SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "HICKERSON",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "BARTLETT",
        "authorized_official_title_or_position": "OWNER/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "916-397-4045",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, BCBA, LBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "LA",
            "license": "L-155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "S.T.A.R.S. Consulting, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gretna, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.